Health vs M.O.T

Picture this. You’ve got a really rubbish car, the dealer cheated you and you’ve got left with something which breaks down every couple of weeks. Except, every time it’s a different problem, so you take it to the same mechanic who fixed it for you last time and for some reason they say ‘no, sorry. I can’t help, you have to take it to the bloke down the road, he’s an expert in it‘. But you used the little life the car had left in it to get it to the first mechanic, and you’re thinking ‘holy crap, why can’t this guy fix it for me, he fixed it last time, how the hell am I going to get it to the next mechanic?‘ So you manage somehow, and you get there and mechanic number 2 says ‘yeah I can fix it, I can see what the problem is, but it’s linked to the last problem you had, which I don’t know a lot about. Can you explain it for me please?‘ You look at him a bit blankly and then enter into an explanation which you’re hoping mechanic number 2 understands, but there’s a lot of technical words and you’re pretty sure you’ve missed some of the information out, and you don’t particularly want your engine to blow out when you’re doing 70mph on the motorway, so you need to get it right. There’s four potential replies mechanic number 2 can say to you:

  1. ‘I’ve no idea what you’re talking about, wait until you get the paperwork from mechanic number 1, or go back and ask him to write it down properly.’
  2. ‘I think I get what the problem is, does it sound like….? ‘ and he recounts a lot of right-sounding words which makes you both feel like you understand what’s going on.
  3. ‘Yes, I know exactly what this is’ but he actually doesn’t have a clue and is just winging it and hoping for the best.
  4. ‘yes I know exactly what this is’ and actually does know what it is and can help you.

He can’t fix it there and then anyway, you have to make an appointment. So you somehow have to get your car back home, use it in the week for what you need it for and then get it back to him at some point. I’m sure everyone’s had a moment where they’re squinting at their car as they start it, holding their breath and hoping that the engine kicks into life.

Now imagine that your car is a really, really bad car, and you keep having to repeat the scenario above and have had 20 mechanics (and counting) and have had to go up and down the chain for each one. You start to miss out bits which may or may not be relevant because you’re so confused as to what the problem might be, or you can’t remember what you’ve said to them all. There’s no option of changing mechanic, and all of them seem nice on the surface, so even if they were fobbing you off, you’d find it hard to work out until after. Realistically, you’d be changing the car by now.

That’s pretty much what it’s like being a ‘complex patient’. Except I am the car and the mechanics are the different healthcare professionals. And that doesn’t even factor in when I’ve had to call the RAC out for roadside assistance and the complications which follow with that.

It’s hard work. You get to a point, just like you do with a car, where you start thinking ‘do I really need to bother with this? Is it worth the effort?‘ Because you know that if you whack your car on a specific part of the dashboard, the electrics will work again for a while. Or in my case, for example, I can put up with my heart missing out and adding in beats because I know if I hold my breath for 30 seconds it falls back into a normal rhythm. At some point you know you should figure out what’s going on with that specific bit, but the biggest problem is the massive hole in your petrol tank which is leaking fuel everywhere, so that needs dealing with first.

There are a few things I wish my doctors knew when dealing with all of the separate problems:

  • It’s stressful being the ‘go between’. It’s a lot of pressure to remember things. And I have no idea what’s relevant and what’s not, so they either need to make time to hear the whole lot or ask pertinent questions.
  • It’s exhausting. Your patience and resolve starts to wear thin. You keep getting told ‘the next person will help you’ and it feels like that person never comes.
  • I’m not a doctor. I might know a lot about certain bits, but that isn’t an invitation to deliver information in the same vein as if I were a doctor, and I also shouldn’t be held responsible if I’ve misunderstood something. It’s down to the doctors to make sure I can understand.
  • It would be really, really great if people read the information given to them beforehand in my notes. I get that the NHS is overworked and underpaid, but I’m also overworked, just in a ‘I’m sick’ way.
  • Sometimes, people see you as a bunch of separate conditions and you become ‘not their problem’. But I am a whole person- you wouldn’t like it if one mechanic sprayed half your car in one colour of spray paint and another one chose a different colour. That’s what it feels like, sometimes, when people start separating out the illnesses in me and concentrating solely on their area of expertise.

Cars have the bonus of having MOTs, where someone looks over the whole car and makes sure that it’s running safely. In theory, this is the role of the GP. Except in my case, it’s like a Ferrari showing up at your local garage for an MOT- they could do it if they got the manual out, but everyone’s a bit too scared to touch it in case they do something to make it run badly. (I’m clearly not a Ferrari!)

I don’t want to be written off, but it can sometimes feel like it when time is short in an appointment. It’s always nice if the garage has time to valet your car for you, or, in my case, if Doctors check how I’m dealing with everything going on emotionally. You feel you’ve had good customer service if the garage rings you after a couple of weeks, to make sure the car’s still working well for you.

There are good mechanics and bad mechanics, just like there are good HCPs and not so good ones. But cars can recycle elements of their chassis if things go wrong, it’s not as easy to do that in people. Which makes finding the right mechanic who won’t fob you off even more important.

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